- Management of renal failure in end-stage liver disease: A critical appraisal. [Review]
- LTLiver Transpl 2016; 22(12):1710-1719
- Renal failure is a late consequence of end-stage liver disease (ESLD). Even with liver transplantation, pretransplant renal impairment remains a strong predictor of posttransplant mortality. This rev...
Renal failure is a late consequence of end-stage liver disease (ESLD). Even with liver transplantation, pretransplant renal impairment remains a strong predictor of posttransplant mortality. This review seeks to summarize and critically appraise common therapies used in this setting, including pharmacologic agents, procedures (transjugular intrahepatic portosystemic shunt, renal replacement therapy), and simultaneous liver-kidney transplantation. More experimental extracorporal modalities, eg, albumin dialysis or bioartificial livers, will not be discussed. A brief discussion on the definition and pathophysiologic underpinnings of renal failure in ESLD will be held at the beginning to lay the groundwork for the main section. Liver Transplantation 22 1710-1719 2016 AASLD.
- Second vascular access after failure of the first fistula in the elderly . [Journal Article]
- CNClin Nephrol 2016; 86 (2016)(11):253-261
- CONCLUSIONS: Since the success rate to avoid the use of a catheter was significantly higher in the AVG2 group than in the AVF2 group, an AVG may be a preferable choice of second access in certain patients, especially in females, blacks and those with PVD. .
- Can We Predict the Unpredictable after Vascular Access Creation? [Editorial]
- CJClin J Am Soc Nephrol 2016 Sep 14
- Right Heart Catheterization via Dialysis Arteriovenous Shunts in End-Stage Renal Disease Patients. [Journal Article]
- JIJ Invasive Cardiol 2016; 28(12):480-484
- CONCLUSIONS: AV dialysis shunts can be used for venous access for right heart catheterization with acceptable feasibility and patient tolerability. Further randomized studies are needed to confirm the benefits of this approach compared with other approaches.
- [Alternative variants of formation of permanent vascular access for hemodialysis]. [Journal Article]
- ASAngiol Sosud Khir 2016; 22(3):164-7
- A native arteriovenous fistula is the most preferred type of a permanent vascular access (PVA) amongst the patients on programmed haemodialysis. Complications of vascular accesses leading to their lo...
A native arteriovenous fistula is the most preferred type of a permanent vascular access (PVA) amongst the patients on programmed haemodialysis. Complications of vascular accesses leading to their lost with time would eventually and unavoidably result in exhaustion of the vascular recourses of the patient thus creating posing a problem while forming yet another PVA. Taking into consideration vitally important necessity of carrying out haemodialysis procedures for these patients, vascular surgeons have to search for alternative variants of access to the vascular bed. According to the KDOQI guidelines, in case of full loss of suitable vessels on upper limbs, formation of PVA may be possible in the area of the femur and in the upper third of the chest, predominantly with the use of a prosthesis as a shunt. Presented in the article are different variants of PVA whose creation was dictated by impossibility of using standard approaches to treatment of such patients.
- Pragmatic, Precision Medicine Approaches for Dialysis Vascular Access Dysfunction: Challenges and Opportunities. [Editorial]
- CJClin J Am Soc Nephrol 2016 Sep 07; 11(9):1525-6
- Comorbidities, Hospitalization, and Living Status of Dialysis Patients Over 80 Years. [Comment]
- BPBlood Purif 2016; 42(4):282-286
- CONCLUSIONS: Dialysis patients aged ≥80 years have a satisfactory quality of life with no more complications than younger patients.
- A Prospective, Randomized Trial of Routine Duplex Ultrasound Surveillance on Arteriovenous Fistula Maturation. [Journal Article]
- CJClin J Am Soc Nephrol 2016 Aug 24
- CONCLUSIONS: Postoperative routine duplex surveillance failed to prove superiority compared with selective duplex after physical examination for reducing arteriovenous fistula maturation failure. However, the wide 95% confidence interval for the effect of intervention precludes a firm conclusion that routine duplex surveillance was not beneficial.
- Right Ventricular Enlargement within Months of Arteriovenous Fistula Creation in 2 Hemodialysis Patients. [Journal Article]
- THTex Heart Inst J 2016; 43(4):350-3
- Surgically created arteriovenous fistulae (AVF) for hemodialysis can contribute to hemodynamic changes. We describe the cases of 2 male patients in whom new right ventricular enlargement developed af...
Surgically created arteriovenous fistulae (AVF) for hemodialysis can contribute to hemodynamic changes. We describe the cases of 2 male patients in whom new right ventricular enlargement developed after an AVF was created for hemodialysis. Patient 1 sustained high-output heart failure solely attributable to the AVF. After AVF banding and subsequent ligation, his heart failure and right ventricular enlargement resolved. In Patient 2, the AVF contributed to new-onset right ventricular enlargement, heart failure, and ascites. His severe pulmonary hypertension was caused by diastolic heart failure, diabetes mellitus, and obstructive sleep apnea. His right ventricular enlargement and heart failure symptoms did not improve after AVF ligation. We think that our report is the first to specifically correlate the echocardiographic finding of right ventricular enlargement with AVF sequelae. Clinicians who treat end-stage renal disease patients should be aware of this potential sequela of AVF creation, particularly in the upper arm. We recommend obtaining preoperative echocardiograms in all patients who will undergo upper-arm AVF creation, so that comparisons can be made postoperatively. Alternative consideration should be given to creating the AVF in the radial artery, because of less shunting and therefore less potential for right-sided heart failure and pulmonary hypertension. A multidisciplinary approach is optimal when selecting patients for AVF banding or ligation.
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- Impact of Staphylococcus aureus protein A (spa) genetic typing in cases of prosthetic shunt graft infections. [Journal Article]
- GGefasschirurgie 2016; 21(Suppl 2):59-62
- CONCLUSIONS: Genetic typing of spa is a suitable technique for distinguishing between nosocomial and community acquired sources of prosthetic shunt graft infections.